The harmless observations of Ugandan, Paul Busharizi. Is it me or are we missing something here?

Tuesday, May 20, 2014

CRIMINALIZING HIV TRANSMISSION COUNTERPRODUCTIVE

The
passing into Law last week of the HIV Prevention & Control Bill
2010 while trying to control the HIV pandemic may fuel instead of stall
the spread of the virus.

The
promoters of bill sought to create a legal framework for the prevention
and control of HIV, disclosure of sero-status to reduce transmission,
provision of testing and counseling services and prescribing penalties
for intentional transmission of HIV.

On
the surface of it the motives behind the bill are noble even laudable
but we know that even the road to hell is paved with good intentions.

One
sees this bill as knee jerk reaction to the recent increases in HIV
prevalence after the country had for many years registered consistent
success in slowing the rate of new infections.

Two
of the most controversial clauses criminalize the transmission of HIV.
Clause 39 seeks to penalize anyone who "attempts to transmit HIV" to
another person to a fine or/and upto five years behind bars, while
clause 41 goes after people who "willfully and intentionally transmit
HIV" to a fine or/and imprisonment of up to 10 years.

The
major danger with this is that it stigmatizes pele with the virus, a
throw back to the early days of the pandemic when, driven by fear,
societies were most likely to deny the existence of the challenge at
best or ostracize victims entirely.

Uganda,
hobbled by a lack of resources in the 1980s determined that the best
thing was to be open about the problem even though it might have
affected the economy in lost earnings from tourism for example. The net
out come was that Uganda came to grips with the pandemic long before
our more conservative neighbours allowing us to roll back its deadly
advance.

Once resources were available widespread testing for HIV helped in helping people access treatment and alter their behavior.

In
determining that a criminal act has been committed this new law
presupposes that the one trying to infect knows their HIV-status or at
least that the law will be more punitive if it can be proved that one
knew they were carrying the virus and indulged in risky sexual behavior.

This
might have the effect on discouraging people for going for testing in
an effort to prevent from future liability under this law.

If
this is the outcome it would be a significant step backward in the war
against AIDS. It has been an uphill task to get people to voluntarily
present themselves for testing the last thing we need is for that
momentum to be slowed or reversed altogether.

One
can understand the desire to criminalize transmission of the virus than
say transmitting Other sexually transmitted infections or cholera or
Ebola. In sub- Saharan Africa nine in ten infections are through sexual
intercourse, it therefore threatens our need to procreate and also
probably the only source of pleasure for the majority of people, dare I
say.

But
we know that not all people carrying the virus contracted it through
immoral behavior and so deserve their fate, as the hypocritical
moralists among us maintain. Some are children, victims of sexual
violence or contracted it through blood transfusion. But closer to home,
women who are largely not in control of their sexuality may fall victim
to this because all pregnant women are tested for the virus and their
significant others may accuse them of infecting them, as the technology
to know who infected who has not been developed.

It
does not help that HIV transmission has been criminalizes in the west
so the opposition to these kind of laws sound like voices in the
wilderness.

Advances
in HIV research mean that infection is no longer a death sentence, with
life expectancy of victims now up to as high as 75. But in order for
those infected to be treated effectively they need to test as soon as
possible. Stigmatizing them only makes this that more difficult.

Clearly
fear is driving this kind of legislation. The only way to combat fear
is through knowledge, as the successful campaign against the epidemic
showed in the 1980s. This is not an abstract concept to us in Uganda we
know this through hard experience.

It
sounds counter intuitive but knowledge rather than punitive measures
are definitely where the continued gains against HIV will be made.